Five Tips on Point-of-Service Collections

Point-of-service collections have become more important to hospitals as high-deductible policies become more common and more patients are uninsured, says Suzanne Lestina, director of revenue cycle at the Healthcare Financial Management Association. Such payments make up 5-6 percent of total net revenue and 16-17 percent of outstanding receivables, she says. Here Ms. Lestina offers five tips on improving point-of-service collections.

1. Engage patients at point of service. Even in the ED, which is subject to restrictions under the federal EMTALA law, hospital personnel can ask for money as long as it does not delay the provision of on-time services. For example, the bill could be discussed when the patient is waiting for test results. Simply sending a bill to the patient afterwards reduces the odds of it being paid. For a planned hospital visit, it's even better to talk about the bill before the point of service, at preregistration, so patients can be sure to bring the payment with them.

2. Set expectations about payment. The patient needs to know how much a service will cost before it is provided. Ms. Lestina says it's human nature: people who do not know the cost of a service are less likely to pay for it. "In every other industry, you don’t buy something if you don’t know the cost," she says. Patients who know the exact cost can make a commitment on how much they will pay immediately and how they will pay over time, and they are more likely to comply with an agreed-upon payment schedule.

3. Make sure billing data is accessible. Being able to estimate what a patient owes right at the point of service requires access to billing data from both payors and the hospital's own systems. This means having an advanced IT structure with relatively seamless dataflow. Some payors, however, may still require a phone call.

4. Get clinical staff's buy-in. Patients will be less likely to pay their bills if they are confronted with mixed messages about the necessity of payment. "It's important to have buy-in from clinical staff," Ms. Lestina says. "Nurses and doctors need to understand the importance of this." But don’t require clinical staff to discuss charges. They have a different priorities and skill sets.

5. Use trained financial counselors. Clinical staff should send patients to financial counselors in the billing department. Billing staff without experience in financial counseling will need training in such matters as asking for money, which can be awkward for untrained individuals.  

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